• INTRODUCTION
    • Compartment syndrome of the leg is an orthopaedic emergency and can be treated with single or dual-incision fasciotomy, allowing for necessary decompression of all four compartments.
  • STEP 1 SINGLE-INCISION TECHNIQUE POSITION THE PATIENT
    • Place the patient supine with a bump underneath the ipsilateral buttock.
  • STEP 2 SINGLE-INCISION TECHNIQUE MAKE THE SKIN INCISION
    • An incision centered over the posterolateral aspect of the leg provides access to all four compartments of the leg.
  • STEP 3 SINGLE-INCISION TECHNIQUE DECOMPRESS THE SUPERFICIAL POSTERIOR LATERAL AND ANTERIOR COMPARTMENTS
    • Make longitudinal fascial incisions, approximately the length of the skin incision, in the superficial posterior, lateral, and then anterior compartments.
  • STEP 4 SINGLE-INCISION TECHNIQUE DECOMPRESS THE DEEP POSTERIOR COMPARTMENT
    • Using the lateral intermuscular septum as a guide to reach the posterolateral aspect of the fibula, release the fascial attachment of the deep posterior compartment from the fibula.
  • STEP 5 SINGLE-INCISION TECHNIQUE POSTOPERATIVE PROTOCOL
    • After appropriate operative fixation and/or debridement of nonviable tissue, dress the wounds with a VAC device.
  • STEP 1 DUAL-INCISION TECHNIQUE POSITION THE PATIENT
    • Position the patient, administer antibiotics, and prepare and drape the limb as described in Step 1 for the single-incision technique.
  • STEP 2 DUAL-INCISION TECHNIQUE MAKE THE ANTEROLATERAL SKIN INCISION
    • Make an incision centered over the anterolateral aspect of the leg to provide access to the anterior and lateral compartments of the leg.
  • STEP 3 DUAL-INCISION TECHNIQUE DECOMPRESS THE ANTERIOR AND LATERAL COMPARTMENTS
    • Make a longitudinal fascial incision in the anterior compartment anterior to the intermuscular septum and a separate longitudinal incision for decompression of the lateral compartment posterior to the intermuscular septum.
  • STEP 4 DUAL-INCISION TECHNIQUE MAKE THE POSTEROMEDIAL SKIN INCISION
    • Make an incision centered over the posteromedial aspect of the leg to provide access to the superficial and deep posterior compartments of the leg.
  • STEP 5 DUAL-INCISION TECHNIQUE DECOMPRESS THE SUPERFICIAL AND DEEP POSTERIOR COMPARTMENTS
    • Through the posteromedial skin incision, identify both the deep and the superficial posterior compartments and incise their fascia longitudinally for adequate decompression.
  • STEP 6 DUAL-INCISION TECHNIQUE POSTOPERATIVE PROTOCOL
    • Follow the same postoperative protocol as outlined in Step 5 for the single-incision technique.
  • RESULTS
    • Both the single and the dual-incision techniques are effective for relieving elevated intracompartmental pressures to prevent myonecrosis.IndicationsContraindicationsPitfalls & Challenges.